Prevalence and correlation of glycemic control achievement in patients with type 2 diabetes in Iraq: A retrospective analysis of a tertiary care database over a 9-year period

Diabetes Metab Syndr. 2020 May-Jun;14(3):265-272. doi: 10.1016/j.dsx.2020.03.008. Epub 2020 Mar 26.

Abstract

Background: This study was designed to assess the achievement of a glycated hemoglobin (HbA1c) target in Iraqi type 2 diabetes mellitus (T2DM) patients via retrospective analysis of a tertiary care database over a 9-year period.

Methods: A total of 12,869 patients with T2DM with mean (SEM) age: 51.4(0.1) years, and 54.4% were females registered into Faiha Specialized Diabetes, Endocrine and Metabolism Center(FDEMC) database between August 2008 and July 2017 were included in this retrospective study. Data were recorded for each patient during routine follow-up visits performed at the center every 3-12 months.

Results: Patients were under oral antidiabetic drugs (OAD; 45.8%) or insulin+ OAD (54.2%) therapy. Hypertension was evident in 42.0% of patients, while dyslipidemia was noted in 70.5%. Glycemic control (HbA1c <7%) was achieved by 13.8% of patients. Multivariate analysis revealed <55 years of age, female gender, >3 years duration of diabetes, HbA1c >10% at the first visit, presence of dyslipidemia, and insulin treatment as significant determinants of an increased risk of poor glycemic control. BMI <25 kg/m2 and presence of hypertension were associated with a decreased risk of poor glycemic control.

Conclusion: Using data from the largest cohort of T2DM patients from Iraq to date, this tertiary care database analysis over a 9-year period indicated poor glycemic control. Younger patient age, female gender, longer disease duration, initially high HbA1c levels, dyslipidemia, insulin treatment, overweight and obesity, and lack of hypertension were associated with an increased risk of poor glycemic control in Iraqi T2DM patients.

Keywords: Basrah; Glycemic control; HbA1c target; Iraq; Type 2 diabetes mellitus.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Body Mass Index
  • Databases, Factual
  • Diabetes Complications / epidemiology
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Female
  • Glycated Hemoglobin / analysis
  • Glycemic Control*
  • Humans
  • Hypertension / complications
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Iraq / epidemiology
  • Male
  • Middle Aged
  • Obesity / complications
  • Obesity / epidemiology
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Tertiary Healthcare

Substances

  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin